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Why Obesity Matters

As a midwife, I am interested in a woman’s pregnancy outcome. But as I said earlier this week, a woman is not just a uterus. I care about the whole woman, her health not just through this pregnancy but throughout the rest of her life. I hope that through her interactions with me a woman is able to take at least one step closer to her optimal health.

Yes, obesity increases the risks of some problems in pregnancy. But the risks for obesity do not stop there. Obesity predisposes a woman to some forms of cancer. Obese individuals are more likely to have diabetes and cardiovascular problems – which put her at great risk for serious issues like blindness, kidney failure, heart attack or stroke. Obesity diminishes not only quantity, but quality of life.

Obesity is not a benign condition. It isn’t just extra fat sitting on your body. Fat tissue is functional tissue in the body. It secretes chemicals and absorbs chemicals. It changes the way your body works. Obese women have a lower 5-year survival rate after cancer than their leaner counterparts. Obesity rivals smoking as a leading cause of cancer.

Obesity matters because a woman will have serious health problems due to the obesity if she is not able to be successful at maintaining a healthy weight. Ideally a woman would lose the weight before becoming pregnant, but of all the overweight people I know, very few are successful at losing the weight despite nearly 100% trying to lose weight. Pregnancy is a unique time in that the woman is able to communicate with a health care professional regularly. Pregnancy may be the first time she has someone willing to help her find solutions to the problems that are preventing her from reaching a healthy weight. Pregnancy may be the first time she realizes obesity may be the symptom and not the disease, the first time she has access to tests that can identify hormonal imbalances. Pregnancy may be the first time someone helps her see that she could benefit from counseling or working with a nutritionist. Pregnancy may be the first time she doesn’t feel like she is fighting this battle alone. And isn’t that why we are there as midwives? To support our clients in achieving their health goals for this pregnancy and beyond?

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Jennifer Vanderlaan CNM MPH is the author of the BirthingNaturally.net website. She has been working with expectant families since 2000, training doulas, childbirth educators, and midwives. She has worked with midwives in Central America and Sub-Saharan Africa. Her interest in public health grew in 2010, and she is now a PhD student learning to become a producer of knowledge.